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Updated: Jul 14, 2026

Modified Posterior Vertebral Column Resection for Patients with Thoracolumbar Kyphotic Deformity
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Modified Posterior Vertebral Column Resection for Patients with Thoracolumbar Kyphotic Deformity

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Concave rib osteotomy: a modified technique revisited.

Mohamed A El Masry1, Ablaa M Saleh, Anthony B McWilliams

  • 1Department of Orthopaedics, Leeds Teaching Hospitals, Leeds, West Yorkshire, LS9 7TF, UK. drmedoelmasry@yahoo.co.uk

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
|June 16, 2007
PubMed
Summary

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A modified Concave Rib Osteotomy (CRO) technique combined with posterior fusion effectively corrects severe adolescent idiopathic scoliosis. This approach offers a safe alternative to anterior release, with significant spinal correction and manageable pulmonary complication rates.

Area of Science:

  • Orthopedic Surgery
  • Spinal Deformity Correction
  • Adolescent Idiopathic Scoliosis Research

Background:

  • Adolescent idiopathic scoliosis (AIS) often presents with severe, rigid spinal curves requiring complex surgical intervention.
  • Traditional surgical techniques, such as anterior release, carry specific risks and limitations in managing these challenging cases.

Purpose of the Study:

  • To evaluate the efficacy and safety of a modified Concave Rib Osteotomy (CRO) technique when used with posterior instrumented fusion for severe and rigid AIS.
  • To compare the outcomes of this modified CRO approach with established anterior release methods.

Main Methods:

  • A prospective study design was employed to assess patients undergoing the modified CRO and posterior instrumented fusion.
  • Surgical technique involved a modified CRO procedure followed by posterior spinal instrumentation and fusion.

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  • Post-operative outcomes, including frontal plane correction and pulmonary complications, were meticulously recorded.

    • Main Results:

    • The mean post-operative frontal plane correction achieved was 68%, demonstrating significant efficacy in curve straightening.
    • The incidence of pulmonary complications was reported at 11.5%, indicating a manageable risk profile.
    • The modified CRO technique showed promising results in treating severe and rigid spinal deformities.

    Conclusions:

    • The modified Concave Rib Osteotomy (CRO) in conjunction with posterior instrumented fusion is an effective treatment for severe and rigid adolescent idiopathic scoliosis.
    • This surgical modification presents a safe and viable alternative to anterior release procedures for this patient population.
    • Further research can explore long-term outcomes and refine the technique for optimal patient benefit.